445202597-9-19-2024-26-AS-KHOS-D9LVE6-20240930162149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 445202597
Report Date: 09/19/2024
Date Signed: 09/19/2024 04:13:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2022 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 26-AS-20220817163154

FACILITY NAME:	WESTWIND MEMORY CARE		FACILITY NUMBER:	445202597
ADMINISTRATOR:	STEVEN SILACCI		FACILITY TYPE:	740
ADDRESS:	160 JEWELL STREET		TELEPHONE:	(831) 421-9100
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY:	59	CENSUS: 55	DATE:	09/19/2024
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Steven Silacci		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Residents care plans are not regularly updated
Staff are not conducting accurate assessments for the residents
Staff are not abiding to the admission agreement
Staff do not have planned activities fro the residents
Staff behavior poses as a risk to residents while in care

INVESTIGATION FINDINGS:

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On 9/19/24, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint investigation visit. LPA met with Executive Director, Steven Silacci and explained the purpose of today's visit.

Regarding the allegations Residents care plans are not regularly updated, Staff are not abiding by admission agreements, Staff do not have planned activities that are suitable to resident needs, Staff are not being properly trained for residents with dementia, Staff are not providing adequate food service to the residents. LPA Donato tried to call RP, but RP is no longer available to be able to get more information on these allegations.

LPA Heberle was able to interview the Activities Director (AD), and it was stated that there are 3 activities per day, one in the morning, afternoon, and evening. AD plans additional activities based off of personal likes profiles that are developed. AD puts on different music and shows based off of what residents requests. In the morning they do exercises, but walks happen all the time. The first floor especially does a lot of walks because of the garden. Residents on the second floor often don't come down. Residents on the second floor are content to simply walk up and down the halls, which activities staff assists them with.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jackie Jin	TELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: Grace Donato	TELEPHONE: 714-293-8294
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20220817163154

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: WESTWIND MEMORY CARE	FACILITY NUMBER: 445202597
	VISIT DATE: 09/19/2024

NARRATIVE

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Another staff member (S2) mentioned that training is pretty good, it would be more helpful if they had trainings on specific residents, rather than general training. Staffing levels are good, it's a challenge during call offs but there are typically 3 to 4 RAs per floor.

Based on interviews and records review, the department has determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Report is reviewed and copy is provided.

SUPERVISOR'S NAME: Jackie Jin	TELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: Grace Donato	TELEPHONE: 714-293-8294
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC9099 (FAS) - (06/04)

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